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Lyme disease is a multisystemic disorder caused by an epizootic organism of the spirochete group, called Borrelia burgdorferi (Bb), which is transmitted to humans by ticks of the genus Ixodes.1 Three sequential clinical stages have been described: (i) early localised; (ii) early disseminated; and (iii) late persistent disease. Lyme neuroborreliosis may occur during the early dissemination phase, most often as a painful meningo-radiculitis and very rarely as a radiculo-myelitis, whereas encephalomyelitis is observed in the late phase.2 We report the case of a patient with an early subacute poliomyelitis-like syndrome closely matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on magnetic resonance (MR) imaging.
A previously healthy 21-year-old man presented in September 2006 with painless weakness in both arms that had increased over a period of 2 weeks. He had a short history of neck pain and stiff neck 2 months previously, which had spontaneously resolved. An indepth retrospective anamnesis failed to reveal any evidence of tick bites or erythema chronicum migrans, but the patient had undertaken open air activities in a woody countryside …
Competing interests: None.
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